Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
fruits veggies colorful

5 Ways to Amp Up Your Nutrient Intake

Thanks to fad diets, everyone has their own idea of what constitutes a healthy diet – and has a mental list of which foods will never touch their lips again. We’ve all been there: Low-Carb, No-Carb, Paleo, South Beach, Atkins, Gluten-Free, Foods That Match Your Eye Color – you name it. But these diet trends simply cherry-pick a few nutritional facts, served up alongside lots of disinformation.

The simple truth is that a healthful, nutritionally favorable diet means consuming a variety of vegetables, fruits, legumes, nuts, seeds and herbs. Fun fact: each and every plant food has its own distinct nutritional profile. More importantly: there are over 100,000 biologically active chemicals found in plants, agents that offer anticancer, antimicrobial, antioxidant, analgesic, and wound healing effects.

So how do you get those active chemicals to up our chances of living a long and healthy life? Let’s break it down:

1. Eat “the rainbow,” using a variety of natural plant foods.

Ensure that you consume a wide range of phytonutrients, many of which are antioxidants that offer a range of health benefits, from helping you lose excess weight and preventing disease, to slowing brain degeneration. The red in tomatoes comes from lycopene, the orange in carrots and sweet potatoes from alpha- and beta-carotene, the blues and reds of berries from anthocyanins, and the green in spinach and kale from lutein and chlorophylls. A variety of colors means a variety of health-promoting nutrients. 

2. The next time you load up at the grocery store, be sure your cart has these Superfoods.

Greens, Beans, Onions, Mushrooms, Berries and Seeds, known collectively to Nutritarians as G-Bombs. The planet’s best foods should be a part of everyone’s diet every day. Why? According to Dr. Fuhrman, these six magical foods benefit the immune system, can make you slim and healthy, and keep you that way while protecting you from cancer. Here’s just a taste of the power they possess and a simple recipe to help you reap some of their amazing benefits:

  • Greens, cruciferous vegetables in particular provide unique phytochemicals (ITCs) with a variety of cancer-fighting effects. Greater consumption of these vegetables is linked to reduced risk of cancer and cardiovascular disease and a longer life.1-3
  • Beans and other legumes  are rich in fiber and resistant starch, which help keep blood glucose, blood pressure, and LDL cholesterol down, promote weight loss, promote colon health, and nourish the microbiome.4-7
  • Onions and garlic are linked to a reduction in the risk of several cancers, and their distinctive sulfur-containing phytochemicals have a number of actions that benefit the cardiovascular system.8-11
  • Mushroom phytochemicals are unique in their promotion of immune system function and their abiity to inhibit of estrogen production; mushroom consumption is associated with a reduced risk of breast cancer.12-15
  • Berry phytochemicals have anti-cancer and blood pressure-lowering effects, and are linked to a reduced risk of heart attack.  Blueberries in particular have also shown promise for improving brain health, in studies on memory and cognitive function.16-22
  • Seeds and nuts: Eating nuts regularly is associated with longevity, reduced risk of cardiovascular disease, and a healthy body weight. Different seeds have different nutritional benefits; flax and chia, for example, are rich in omega-3 ALA and lignans, anti-estrogenic phytochemicals linked to a reduction in breast and prostate cancer risk.23-27

3. Focus on the nutrient-density of your diet.

A standard weight loss “diet” is one that focuses on controlling portion size and cutting down on junk food. The absolute best diet is one that concentrates on the amount of nutrients that food can provide and their phytonutrient power to protect against cancer. Natural foods with a high nutrient-density contain a significant amount of vitamins, minerals and other healthful substances with respect to their calories. This way of eating, called a Nutritarian Diet, has surged in popularity just as interest in the health benefits of various ingredients – kale, turmeric, berries – has spiked. Superfoods describe not only G-Bombs, but many others, too. For the list of some of Dr. Fuhrman’s must-eat foods, download his infographic 10 Best and 10 Worst Foods. Or for a deeper dive into the foods that benefit health and longevity, read Dr. Fuhrman’s magazine to learn his choices for the planet’s 100 Best Foods.


4. 
Break the junk food habit.

Processed junk foods are incredibly harmful to our health. They lead to obesity and illness, and cause detrimental chemical changes in the brain, affecting our emotional well being and drive cravings for more junk food. Eating junk food is a learned habit. These foods need to be eliminated entirely from your diet.

Kick start your transformation by cleaning out your refrigerator and pantry so you won’t be tempted with unhealthy foods. Here’s some easy ways to start:

  1. Sauté with water or low-sodium vegetable broth instead of oil
  2. Switch from cow’s milk to unsweetened soy, hemp, or almond milk
  3. Switch from sugar-sweetened breakfast cereal to steel cut oats topped with flax or chia seeds and berries
  4. Add tofu into a veggie scramble instead of eggs
  5. Say no to cheese
  6. Finish your meals with fresh fruit rather than sugary desserts

5. Don’t snack on healthy foods, either.

Learn to eat only at mealtimes, and only when you are hungry. If you are hungry between meals, it means you didn’t eat enough during the meal, so adjust your portions accordingly. Refraining from snacking might be hard to do at first, but it will become second nature after a while.  It is especially important not to eat after dinner before bedtime.

Join Dr. Fuhrman for his free webinar, Eat to Beat Cancer (and COVID)

 


Article originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.

Joel Fuhrman, MD is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 7 New York Times bestselling books, including his most recent book, “Eat to Live”. Visit his website, DrFuhrman.com.

 

References:

  1. Zhang X, Shu XO, Xiang YB, et al. Cruciferous vegetable consumption is associated with a reduced risk of total and cardiovascular disease mortality. Am J Clin Nutr 2011, 94:240-246
  2. Pollock RL. The effect of green leafy and cruciferous vegetable intake on the incidence of cardiovascular disease: A meta-analysis. JRSM Cardiovasc Dis 2016, 5:2048004016661435.
  3. Higdon J, Delage B, Williams D, Dashwood R. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 2007, 55:224-236.
  4. Papanikolaou Y, Fulgoni VL, 3rd. Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002. J Am Coll Nutr 2008, 27:569-576.
  5. Jayalath VH, de Souza RJ, Sievenpiper JL, et al. Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials. Am J Hypertens 2014, 27:56-64.
  6. Bazzano LA, Thompson AM, Tees MT, et al. Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011, 21:94-103.
  7. Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diab tologia 2009, 52:1479-1495.
  8. Rahman K, Lowe GM. Garlic and cardiovascular disease: a critical review. J Nutr 2006, 136:736S-740S.
  9. Powolny A, Singh S. Multitargeted prevention and therapy of cancer by diallyl trisulfide and related Allium vegetable-derived organosulfur compounds. Cancer Lett 2008, 269:305-314.
  10. Bradley JM, Organ CL, Lefer DJ. Garlic-Derived Organic Polysulfides and Myocardial Protection. J Nutr 2016, 146:403S-409S.
  11. Galeone C, Pelucchi C, Levi F, et al. Onion and garlic use and human cancer. Am J Clin Nutr 2006, 84:1027-1032.
  12. Borchers AT, Krishnamurthy A, Keen CL, et al. The Immunobiology of Mushrooms. Exp Biol Med 2008, 233:259-276.
  13. Jeong SC, Koyyalamudi SR, Pang G. Dietary intake of Agaricus bisporus white button mushroom accelerates salivary immunoglobulin A secretion in healthy volunteers. Nutrition 2012, 28:527-531.
  14. Li J, Zou L, Chen W, et al. Dietary mushroom intake may reduce the risk of breast cancer: evidence from a meta-analysis of observational studies. PLoS One 2014, 9:e93437.
  15. Chen S, Oh SR, Phung S, et al. Anti-aromatase activity of phytochemicals in white button mushrooms (Agaricus bisporus). Cancer Res 2006, 66:12026-12034.
  16. Krikorian R, Shidler MD, Nash TA, et al. Blueberry supplementation improves memory in older adults. Journal of agricultural and food chemistry 2010, 58:3996-4000.
  17. Bowtell JL, Aboo-Bakkar Z, Conway M, et al. Enhanced task related brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation. Appl Physiol Nutr Metab 2017.
  18. Stoner GD, Wang LS, Casto BC. Laboratory and clinical studies of cancer chemoprevention by antioxidants in berries. Carcinogenesis 2008, 29:1665-1674.
  19. Cassidy A, Mukamal KJ, Liu L, et al. High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation 2013, 127:188-196.
  20. Cassidy A, O’Reilly EJ, Kay C, et al. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 2011, 93:338-347.
  21. Johnson SA, Figueroa A, Navaei N, et al. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial. J Acad Nutr Diet 2015, 115:369-377.
  22. Whyte AR, Schafer G, Williams CM. Cognitive effects following acute wild blueberry supplementation in 7- to 10-year-old children. Eur J Nutr 2016, 55:2151-2162.
  23. Mattes RD, Dreher ML. Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr 2010, 19:137-141.
  24. Grosso G, Yang J, Marventano S, et al. Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 2015, 101:783-793.
  25. Kris-Etherton PM, Hu FB, Ros E, Sabate J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008, 138:1746S-1751S.
  26. Buck K, Zaineddin AK, Vrieling A, et al. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. Am J Clin Nutr 2010, 92:141-153.
  27. Thompson LU, Chen JM, Li T, et al. Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin Cancer Res 2005, 11:3828-3835.
Food-question

What Makes a Diet “Good”​?

When Mark Bittman and I were working on How to Eat, we spent several full days just talking through every question either of us had ever raised, or received, about all things food. For those who know the book, you will recognize its pedigree in this free-flowing discussion, for the book itself reads like pulling your chair up to our coffee table and joining in the conversation. Of course, the book offers a disciplined structure, the brevity of good editing, and a logical flow its parental chat all lacked- but still, the apple fell in proximity to the tree.

Among the topics that consumed the most time was this: what one thing, above all else, makes a diet “good”?

We agreed on a one-word answer (with nothing but love for the famously apt seven from Michael Pollan), and I will share it momentarily. But first, let’s be careful about “good.” In our polarized world, with our cultural heritage of Manichaeism, “good” all too readily takes on moral overtones. Dietary guidance should not adorn the wag of an admonishing finger. Dietary guidance should not populate the bark of dogma, or be the scion of sanctimony. The “good” in question is of the “good is as good does” variety, not of the “good versus evil” variety. That distinction gets all too murky all too often in the opposing, self-righteous assertions that dominate the pop culture of this social media moment.

Diet good is as diet good does. What good is that?

First, diet tends to be good as a noun (as in “dietary pattern”), and far less good as a verb. When diet implies its gerund- “dieting”- there is little lasting good in the offing. I won’t belabor this, but a lot of truly “bad” ideas can work well for short-term weight loss, all but inevitably followed by weight regain with interest. There is so much wrong with “dieting” that the case could be made – indeed, I’ve made it – that “dieting” should die. We “di-et” alone, we live it- together. Together is better. Together would be good.

But what of that one-word answer? Our choice was: balance. No, not carbs; not saturated fat; not sugar; not sodium. Balance.

To be clear, this is not “balance” of the “all things in moderation” variety; that is a slippery slope toward all manner of dietary debacle. This is “balance” of the good causes require good effects variety, conjoined to a balanced view of what effects truly matter.

A dietary pattern is good if it represents the balanced array of nutrients from an assembly of wholesome foods, mostly plants, that serves our native adaptations. The critical balance is between dietary composition, and metabolic needs. Those vary, of course, by species; a balanced diet for wildebeest involves a lot of grass, while a balanced diet for lions may involve a lot of wildebeest. At its origins, food is about sustenance and survival, and those needs are bounded by the adaptations of a given kind of animal. Protest though we may, we humans are a kind of animal, with a particular suite of adaptations governing the fundamentals of our nutrition requirements.

There is a balance, as well, between health and pleasure. As many of you likely know, Mark, while famously knowledgeable about food systems, is perhaps best known as an expert cook and foodie. The pleasure factor of “good” food is an essential part of the requisite balance that reconciles concepts of how we “should” eat with how we prefer eating. There are bridges that can be built between loving food, and food that loves us back – and on the other side, a balance worth pursuing. Good food gives pleasure; so does good health. Other things being equal, healthy people have more fun. Take a moment, chew on that.

There is, too, a balance in perspective integral to any valid concept of “good” food. Can food be “good” if sourcing it is predicated on overt abuse and torment of our fellow creatures? Few if any decent people want gratuitous cruelty on their menu. Modern dietary patterns conceal a great deal of just that– to creatures that think and feel in all the ways the dogs and cats we call members of our families think and feel. That is an extreme expression of imbalance, a case of cognitive dissonance. The only way to account for behaviors that condone cruelty by people with consciences that renounce it – is a failure to acknowledge what should be common knowledge. Mass-producing animals on factory farms is an unbalanced assault on the sanctity of life.

We must, of course, be in balance with the rest of nature if we are to fill our plates and bellies but not empty the world of its great treasures: fish in the seas, birds in the air, the stunning breadth of biodiversity, pristine aquifers, open grasslands, teeming rainforests. Eating in balance with the competing requirements of a vital planet is not negotiable- for by any other means, we are eating not only our food, but our children’s food, too. When dinner as usual ruins the destiny of our own kind and all others, diet has gone “bad” by any valid connotation.

There is, in addition, the obvious: a “good” diet confers good health. This is intrinsically all about balance. For someone suffering from protein malnutrition, any concentrated source of protein would lead toward a better balance, and thus- be good. For those of us who routinely get far more protein than we need and far too little fiber, it is vegetables, fruits, legumes, and whole grains that tip balance toward the good. As a general rule, getting more of what we get in excess already, or less of what is deficient relative to the set points of adaptation, is movement toward imbalance, and thus bad for that (rather than a moral) reason. There is, for instance, nothing intrinsically pernicious about saturated fat or sodium- but more of these is “bad” when prevailing diets deliver them in excess.

Even sugar isn’t immanently “evil;” in its place, it might fuel the periodic requirements of fight or flight, or feed occasional and relatively innocuous delight. It is rendered decisively “bad,” however, by context, dose, and its contributions to hyperendemic obesity, insulin resistance, pre-diabetes, and their dire, downstream consequences, both chronic, and acute.

Kale and spinach are so good because modern diets deliver such a deficit of leafy greens. Even these, however, would lose their luster in a diet of only kale. Toward balance is good, toward imbalance is bad. This is universal.

We may concede that the willful engineering of addictive junk food, placing corporate profit ahead of public health, is an egregious imbalance in societal priorities. That is fundamentally bad.

Good and bad are…as good and bad do.

Accordingly, what’s good for the goose may not be what’s good for the gander, if the goose is starving as the gander succumbs to obesity, type 2 diabetes, and coronary artery disease. Balance is good for both goose and gander, but the means of redressing the existing imbalance will vary by circumstance.

Finally, “good” is at least partly in the palate of the beholder. Legitimate definitions of dietary good allow for variations in taste- often linked to upbringing, ethnicity, and experience. We don’t fuss over the fact that there is more than one good way to be physically active; we should accommodate the same, balanced perspective about eating.

So much of our discourse on diet is both unduly dogmatic and truly misguided. The prevailing inclination to adjudicate diet quality by invoking macronutrient thresholds- this much fat or that; that much carbohydrate or this- is nearly analogous to judging the merits of exercise by the color of your shoes. More on such macronutrient malarkey – among the great boondoggles of modern nutrition– next time. For now, suffice to say there is more than one way to eat badly- and modern society seems dedicated to exploring them all.

We are fortunate that where so much hangs in the balance- human health and pleasure, planetary health, the treatment of our fellow creatures, the sustainability of food production – “good” populates a confluence. We should not take this for granted; it might have been otherwise. If we were more like great cats- our dietary requirements would diverge from the imperatives of biodiversity and sustainability. We great apes can- if we honor the requisite balance- take good care of ourselves, and the rest of the planet, too.

That would be…good. Because while there are many variations on the basic theme of eating well, there is only one Earth.

Free Webinar with Dr. Katz

The truth about food – for the health of people and planet alike – hides in plain sight, like that infamous elephant in the room no one manages to see. Why is simple truth so hard to perceive? Why does it struggle to prevail?

Join Dr. Katz for this free webinar, The Truth about Food: Of Science, Sense, and Expert Consensus – And All that Conspires Against Them


Article reprinted with permission from Dr. David Katz.

Dr. David Katz is a board-certified specialist in Preventive Medicine/Public Health. He is the Founder and CEO of Diet ID, a company advancing an entirely new way to assess and personalize nutrition, and working to make “diet” the vital sign it deserves to be; and President of the True Health Initiative, a non-profit advancing diet and lifestyle as the best of medicine where science, sense, and global expert consensus meet.

postnatal exercise

Tips on Postpartum Exercise Programming for the Fitness Professional

Many women post-pregnancy are very eager to rejoin the exercise world and at least resume the physical activities they once enjoyed prior to pregnancy. More and more women are seeking out fitness professionals or exercise programs to help them lose the baby weight and engage in safe and effective exercises. Many women understand the toll pregnancy and childbirth took on their bodies and they are ready and willing to seek out professional advice. Working with the postpartum client has benefits for both the trainer and the client. I encourage those who treat this population to get as much education in this area so you can better serve their needs.

Once you begin your journey caring for the postpartum client, there are several important factors to consider when beginning exercise program design.

First, remember she gave birth. Look at birth like any client who is rehabilitating from any type of injury or surgery. The postpartum phase is typically the first 12 months after having a baby but can be longer if a woman is nursing.

Second, consider how long it has been since exercise has been part of her regular routine. Even if she exercised regularly during pregnancy, she probably was limiting the intensity compared to her pre-pregnant self. Keeping that in mind, it may feel like for you (and her) that you are working on a beginner level as you begin.

Third, it’s really important to know the type of birth the woman had and how it affected her pelvic floor muscles. Obviously for vaginal birth pelvic floor prolapse, vaginal tearing or possible Pubic Symphosis diastasis could have occurred. For women who have gone through a cesarean (C-section), the abdominal muscles have been affected through the incision made into the abdominal wall and uterus.

Fourth, it is vital to understand the fitness level of the woman prior to pregnancy and the activities in which she participated. The fitness level or prior activities or sports in which she participated could shape the type of recommended exercises in her program.

Finally, consider any injuries or medical history that may affect her current fitness especially if she has been inactive or just returning back into exercise. Many of this information may be obtained in your initial meeting or phone consultation. You can use a PAR-Q (Physical Activity Readiness Questionnaire) to access this information. I suggest customizing the Par-Q to be very postpartum specific and asking detailed questions about pregnancy and delivery before you begin treatment.

Considering all of these factors, lets now look at how to exercise safely and effectively following delivery.

Procede Gently

Start with basic range of motion exercises and corrective, posture-based movements that will help her body begin to feel restored. A little movement goes a long way.

Get to Know Her Limitations

As with other injuries, or surgeries, childbirth is comparable for your client as her body is still healing, hormones are still adjusting that affect range of motion, core is weak and most women are sleep deprived for months after giving birth. With this in mind, her balance and equilibrium are affected. Careful of movements that change position briskly or go from standing to lying.

Establish Realistic Expectations

Develop reasonable exercise goals for your client. Along with her physical health, mental health is also affected.
Exercise is directly linked in helping to prevent postpartum depression, however, setting fitness goals may create anxiety or worsen her mental state, so be sensitive to this. Start with manageable times to exercise during the week. As the client become stronger you can increase the number of days you exercise per week in addition to the exercise intensity.

Create a Supportive Network

Connecting clients who are going through similar life experiences may help motivate them to exercise more regularly and in a small group setting the cost is usually less per person and more efficient for the trainer for the hour. This may also help give the client additional accountability.

Teach Sustainable Lifestyle Habits

Help your client embrace this journey as a marathon rather than a sprint. Explain that the baby weight will come off but the end goal is to do this safely and cautiously. You must be ready to advise on sustainable, healthy eating habits and adapt if the woman is nursing.

Get Started Working with Prenatal and Postpartum Clients

Check out Danielle Spanger’s online course with MedFit Classroom, Prenatal and Postpartum Exercise, for an introduction to working with this population.


Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com

fitness-dumbells-exercise

How You Can Be the Solution to the Sarcopenia Dilemma and Help Your Older Client’s Thrive

Gene, a 77-year-old retiree, has been in quarantine for the previous 10 months. He was not comfortable leaving his house to go to the gym and has declined invitations to do virtual (online) training. Hence, Gene has lost significant muscle mass, has been prescribed increased quantities of medications for Type II diabetes and high blood pressure. Additionally, his wife reports she has seen his muscle mass, bone density and health rapidly decline. He has lost his appetite and his quality of sleep has also suffered. Gene was prescribed an anti-depressant by his primary care physician to address associated lethargy and depression.   

Joel, an 85-year-old male, has left his house a total of five times in the previous 10 months. Through his wife’s encouragement, he continued his at-home workouts and even increased the frequency of his sessions from two to three times per week once the quarantine moved beyond four weeks. During this time, Joel has increased his lean muscle mass, improved his balance and his wife reports his legs are ‘rock solid and his energy has never been better.’ 

While Joel exemplifies the benefits of maintaining an active lifestyle and improving his muscle mass while in quarantine, he is in the minority. Unfortunately, there are millions of older adults just like Gene who are experiencing the deleterious impacts of quarantine and the sedentary lifestyle on their physical as well as emotional health. This is such a vital and overlooked aspect of health because many older adults may never fully recover in the event they contract a life-threatening disease.

This sentiment is summed up succinctly by (English and Paddon-Jones 2021):

“Thus, with advancing age, it becomes increasingly likely that even a brief, clinically mandated period of bed rest could initiate a serious decline in muscle strength and functional capacity, i.e., a “tipping point” from which some may not fully recover.”

This article will discuss how the Medical Fitness Professional (MFP) who focuses on educating and empowering their older clients can positively impact those experiencing sarcopenia-related health issues. Also included will be a brief discussion about the barriers to exercise suggestions the MFP can implement to address these issues. Finally, MFP’s will be empowered to utilize an education-first strategy while positioning themselves to attract more individuals that will seek out their expertise. 

The Impact of Sarcopenia-Related Multisystem Deconditioning

Sarcopenia, or age-associated loss of muscle density and strength, is a major health problem even when not in a period of quarantine. The loss of muscle mass is associated with all-cause mortality including cardiovascular disease, diabetes, cognitive decline, depression and an increased risk of falls (Kirwan et. al. 2020). The average adult over 30 years of age experiences a 3-8% loss of muscle mass per decade (English and Paddon-Jones 2010). This means that a sedentary individual could literally experience between 9-24% loss of muscle strength and function by the time they reach 60 years of age. Furthermore, 71% of older American males and 42% of older American females present with moderate levels of sarcopenia.

Unfortunately, this problem is exacerbated by periods of forced inactivity, for example, while bedridden. Young adults can experience a 5-6% decrease in muscle strength per week when bedridden (English and Paddon-Jones 2010). Because older adults begin with less lean muscle tissue than their younger counterparts, they are extremely susceptible to multisystem deconditioning and the subsequent health issues associated with the loss of muscle, strength and endurance. 

Sarcopenia is extremely concerning in vulnerable populations (example: older adults) as well as those with comorbidities (example: those with cancer). Muscle atrophy, weakness and pain (myalgia) is even greater after a significant illness and corresponding bedrest. It’s been reported that .5-6% losses in muscle mass per day can occur increasing risk of deteriorating health (Casey et. al. 2021). A 1.7% loss of muscle mass occurs in as little as 2 days and 5.5% after only 7 days of bed rest (Kirwan et. al. 2021). Additionally, 50% of patients experience ongoing myalgia and associated weakness which can last months after recovering from COVID-19 (Casey et. al. 2021). Additionally, the loss of smell, taste and appetite after illness leads to further losses in muscle mass as well as nutritional deficiencies potentially leading to further deterioration of one’s health. 

The Sarcopenia Solution

While its etiology is multifactorial, decreased physical activity and poor nutrition are the two primary aspects contributing to the progressive loss of muscle mass in both the sedentary populations and those with chronic health issues (Kirwan et. al. 2020). Kirwan et. al. recommends that resistance exercise “…be considered of prime importance in attempting to halt and even reverse the progression sarcopenia.” Additionally, Web MD suggests that “The primary treatment for sarcopenia is exercise, specifically resistance training or strength training (downloaded from WebMD 2021). 

While the strength and conditioning industry has long recognized and advocated the benefits of resistance training, getting individuals to comply with the recommended daily activity levels has been a challenge. The challenges to older adults remaining physically active have only been complicated by quarantine. Several organizations including the World Health Organization (WHO) have provided suggestions for getting the recommended 150-300 minutes of vigorous-intensity physical activity per week. To achieve this number while in quarantine, WHO Europe suggests taking short, active breaks, indoor walking and following an online exercise program. 

Since quarantine has forced the closure of many commercial facilities and due to the fact that many older adults are reluctant to leave their house, online or virtual exercise programs have become increasingly popular. Online platforms including but not limited to Zoom, Google and Facebook make it easy to create small group meetings which provide a powerful tool for educating, providing guided exercise programming and increasing socialization, all of which are vital in combatting sarcopenia and isolation-related depression that occurs with prolonged quarantine.  

While historically it has been a barrier to exercising at home, novel equipment such as resistance bands make training at home both practical and functional. Resistance bands provide a low-cost option as compared to free weights (Kirwan et. al. 2021). While Sanchez-Sanchez et. al. (2019) found resistance bands did not provide as much benefit for older adults experiencing sarcopenia as compared to moderate to vigorous exercise, anecdotal finds report contrary findings. Progressive overload utilizing varying tensions of resistant bands and novel anchoring positions has been clinically shown to increase muscle mass, improve joint health and foster confidence in older adults when incorporated into an overall resistance training program (Osar and Linkul 2021). 

In addressing sarcopenia, the importance of nutrition cannot be overstated. High-quality protein (25-30 grams with each meal) to increase muscle mass is part of the lifestyle program recommended by English and Paddon-Jones (2010). Additionally, the consumption of nutrient-dense, calorie-sparse foods like roots, leaves, fruits and seeds can have a positive hormonal effect (Mattioli et. al. 2020) thereby improving mood and quality sleep, both of which are necessary to the overall health and vitality in older adults. 

Solutions to the 3 Greatest Barriers to Resistance Training

Finally, while the benefits of resistance training for addressing sarcopenia are obvious, it would be remiss to leave this article without including a brief discussion covering a few of the barriers to older adults participating in physical activity. One of the greatest barriers for many adults participating in a physical activity program is the reluctance to be proactive about their health care. In part, this is because older adults haven’t been properly educated about the vital importance and their responsibility in self-care. Additionally, even when properly educated, older individuals are rarely given specific instructions and/or directions to achieving success. 

Solution: In addition to the in-session education, the MFP looking to maintain their current clients and wanting to attract more individuals, should dedicate several hours per week to educating their community. Invite current and past clients to participate in a no-cost, regularly scheduled webinar, podcast or virtual training on a relevant health topic. Encourage them to invite their friends, family and colleagues. It is important that these events be education-based rather than focused on selling one’s services. Include at least one simple, actionable health nugget – a bodyweight exercise, mindset habit or healthy shake recipe, for example – that the participants can easily incorporate into their current lifestyle. 

Another important barrier for older adults is the reluctance to seek out a fitness professional because the fitness industry has largely catered their offerings to younger, healthier individuals. This has discouraged countless numbers of individuals from exercising and made it increasingly challenging for the MFP to differentiate their services from the general personal trainer that is often ill-equipped in training the older adult. 

Solution: The number one method for differentiating oneself and to enroll older adults is to highlight current client’s success. Highlighting a current client’s success eliminates the temptation to spend needless time discussing why one’s education is superior to someone else’s. For example, the MFP should highlight clients who can successfully garden or play with their grandchildren or hike because of the resistance training program they’ve been performing. Older individuals need to see, and will, in turn, be empowered by, seeing others just like them achieving success with physical activity programs. Seeing one their own age successfully accomplish things they would like to be participating in will help foster a natural curiosity. This curiosity can ultimately lead to a conversation where the MFP discusses how a tailored program can also help them accomplish their health and fitness goals. 

Additionally, Fitness Professionals like Jackie Bachmeier (Evolution Fitness and Wellness) and Robert Linkul (Training the Older Adult), both of whom cater to training the older adult population, deliver the specific equipment (including resistance bands, hooks and self-myofascial release tools) they want their clients to utilize during their programs. This removes an additional obstacle while adding huge value to the client. 

The third major barrier to online training are technology-associated challenges. While many have legitimate technology challenges, the resourceful and proactive MFP can help remove that obstacle and ease older adults’ in their online transition. 

Solution: Both Robert and Jackie have dedicated specific time to helping technology-challenged clients understand and develop the confidence in using social media and related platforms. While it may seem a hassle in the beginning, when they recognize the relative ease and benefits of online training, many older clients will enjoy the process and in turn encourage their family, friends and colleagues to join in. For example, Jackie’s 83-year-old client Lillian commented that had she realized how easy technology was, she would have done virtual training earlier. She’s since referred her husband and several of her friends to Jackie’s programs. 

Conclusion

Sarcopenia is a rampant problem in older adults, complicating existing health issues and leaving this population particularly vulnerable to prolonged periods of inactivity. Exercise, particularly resistance training, and nutrition are two components that show strong evidence in improving muscle mass, improving health and reducing the risks of all-cause morbidity. By focusing older adults upon the factors within one’s control – i.e., physical activity, nutrition and mindset – the Medical Fitness Professional are well positioned to be the solution for both their current as well potential clients. By addressing the three major barriers to being physically active, the MFP can help their current clients regain their health and, in the process, differentiate themselves and attract more individuals that need, want and will pay for their expertise. By adopting these best-practices, the MFP can successfully position themselves as a major player in the solution to the sarcopenia dilemma.  


Dr. Evan Osar is a Chiropractic Physician, an adjunct faculty member with Rocky Mountain University of Health Sciences (Motor Control) and educator with the Integrative Movement Institute. He has authored “Corrective Exercise Solutions to Common Hip and Shoulder Dysfunctionand Amazon #1 Best Seller, “The Psoas Solution“. He developed the Integrative Movement System™, an evidence-based approach to improving clinical outcomes and helping patients perform at their highest level. Dr. Osar is currently in private practice in Chicago, IL and educates health and fitness professionals that specialize in posture, corrective exercise and medical fitness for the older adult population. 

 

References

Casey P, Ang Y, Sultan J. COVID-19-induced sarcopenia and physical deconditioning may require reassessment of surgical risk for patients with cancer. World J Surg Oncol. 2021 Jan 11;19(1):8. doi: 10.1186/s12957-020-02117-x. PMID: 33430881; PMCID: PMC7798369.

English, K. L., & Paddon-Jones, D. (2010). Protecting muscle mass and function in older adults during bed rest. Current opinion in clinical nutrition and metabolic care13(1), 34–39. https://doi.org/10.1097/MCO.0b013e328333aa66

Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. Geroscience. 2020 Dec;42(6):1547-1578. doi: 10.1007/s11357-020-00272-3. Epub 2020 Oct 1. PMID: 33001410; PMCID: PMC7528158.

Mattioli, A. V., Sciomer, S., Cocchi, C., Maffei, S., & Gallina, S. (2020). Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease. Nutrition, metabolism, and cardiovascular diseases : NMCD30(9), 1409–1417. https://doi.org/10.1016/j.numecd.2020.05.020

Osar, E. and Linkul, R. (2021). The Arthritis Training Solution 2.0. Training the Older Adult Live (Virtual). 

Sánchez-Sánchez, J. L., Mañas, A., García-García, F. J., Ara, I., Carnicero, J. A., Walter, S., & Rodríguez-Mañas, L. (2019). Sedentary behaviour, physical activity, and sarcopenia among older adults in the TSHA: isotemporal substitution model. Journal of cachexia, sarcopenia and muscle10(1), 188–198. https://doi.org/10.1002/jcsm.12369

Web MD. Sarcopenia with Aging. Downloaded 2/15/21 from https://www.webmd.com/healthy-aging/guide/sarcopenia-with-aging

World Health Organization. #healthy at home. Downloaded 2/15/21 from  https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome?gclid=EAIaIQobChMItpfrsInt7gIV7vLjBx1pAwf0EAAYAyAAEgKgTfD_BwE

World Health Organization (Europe). Stay Physically Active During Self Quarantine. Downloaded 2/15/21 from https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine

Fitness-and-Nutrition

Exercise and Nutrition: A Marriage Made in Heaven, But for our Bodies

Many trainers are very well aware of the power of both exercise and nutrition to influence not only our performance but our health as well. Unfortunately, many trainers have made themselves experts in nutrition and are practicing nutritional therapy illegally. Yes, illegally. The nutrition police are not likely to catch you, but just like an unauthorized person can not dispense drugs legally, a trainer should not be giving advice on SPECIFIC diets, designed by themselves, to cure or relieve SPECIFIC diseases or conditions. 

You see how the word specific was capitalized. This was done because trainers CAN give general advice to “apparently healthy” people on what foods can do. They can advise people on a certain diet designed by a nutritionist or physician. They can even advise clients on a supplement’s intended function, but not tell them which SPECIFIC ones to take, or the amounts, especially if there is some clinical condition. The vast majority of trainers are guilty of violating at least one of these conditions. 

Okay, off my soapbox and back to the marriage. Our bodily processes require fuels and use enzymes to perform almost every reaction in our bodies. The vitamins and minerals that we need are known as “essential” because the body either doesn’t produce it, or produce enough of it, to sustain healthy living. Vitamins are organic molecules and are sometimes referred to as coenzymes, and minerals are sometimes referred to as cofactors, because both are needed for different enzymes, or even hormones, to properly function. You probably know that if you are low in iron, the hemoglobin in red blood cells will not properly form, thus, it will not carry oxygen and will result in anemia. The same with iodine and thyroid hormone, and many, many other examples are well known to the public at large. 

Exercise on the other end will stimulate processes like bone-building, and then the calcium, phosphorus, magnesium, sulfur, calcitriol (Vitamin D3), can step in and “do their thing” in depositing a new, stronger bone matrix. Without the stimulus of exercise, there is minimal use of the nutrients and they will be excreted. By the same token, the better the nutrients we put into our body, the better we can perform exercise, recover, build muscle, improve enzyme function, and a whole bunch of other things! 

MedFit Classroom’s Osteoporosis Fitness Specialist online course is also known as “Project BONE” for Beating Osteoporosis with Nutrition and Exercise.  It’s these two simple tools that we can use to actually reverse osteoporosis, not to mention prevent or delay its onset. Many disease conditions can be prevented when we “obey our blueprints”. When we follow the advice of geniuses like Thomas Edison – to have the physician of the future be interested in the food and care of the human frame, or Hippocrates believing walking and food as medicine were essential components of any health care plan. 

The trick is not appreciating the marriage of nutrition and exercise, but getting your client to actually change the way they eat or activities they do. Radical changes almost always end up in radical termination of any change. The popular Transtheoretical Theory of Change, with the various stages of readiness for change, discusses how any major change in behavior is a process, and sometimes a slow, painful one. It takes a lot of effort, both mentally and physically. The Osteoporosis Fitness Specialist course includes a video component called “EAT this, NOT that.” It was named after a popular Men’s Fitness book series, discussing how to substitute one food that is good for you with another that is not.  For example, eating a baked potato with yogurt versus French fries. 

By knowing the “why” you are eating something, and knowing “what” foods have them, as well as “how” to look for it in certain foods, it makes the “when” and “where” to purchase the foods easier. Often people will acquire new favorite foods and perform new “favorite” exercise when they are fun and easy to access. Help this marriage last and spark the romance of exercise and diet in your life. 


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

woman-weight-lifting

Why Women Need to Lift Weights

Traditionally speaking, when it comes to exercise, men have dominated the lifting weights world. This occurred mainly due to men being allowed to participate in sporting activities while women were not allowed to because it was not considered “lady like” and it was illegal. However, times have changed, as women are no longer looked at as being inferior to men; and it is safe, appropriate and very normal for them to exercise, particularly lift weights.

Here are a few reasons why women say they do not need to lift weights and my answer to their concern.

It Will Make Me Look Bulky

While this is a very legit concern, it is typically not true. In order for a woman (or man) to look “bulky”, they will have to do what is called a lot of “volume” in their workouts. Volume is the number of weight, repetitions, sets and exercises done in order to achieve mass or bulk.

If a woman follows the recommended numbers of days of weight lifting/week by ACSM (2-3 days/week, lifting weights for all the major muscles using 1-2 sets of 8-12 reps), they will not get bulky

Lifting Weights Does Not Help Me Burn Calories

Weight lifting has a high metabolic (ability to burn calories) rate. As a result, the more lean muscle a woman has, the less likely she is to gain weight and the easier it is to keep the weight off. Muscles are like the gas in our cars. The gas is used by the engine and keep the car moving.  Having muscle, by lifting weights, allows your body to keep moving and consistently fight off fat gains.

There is No Benefit For Me to Lift Weights

There are tons of benefits of women lifting weights! They include weight loss, improved mood and well-being, better posture and prevention of osteoporosis. These four are all major concerns for most women and lifting weights helps with all of them!

I Only Need to do Cardio to Be Healthy

While doing cardio activities (i.e. running, swimming, elliptical, spin class, etc.) is beneficial for the heart, it does not put the necessary stress on the bone and muscular system that our bodies crave. We were designed in a way that our muscles were meant to be moved beyond just walking and typing on a computer! While cardio is a great way to burn calories, oftentimes, it will burn away muscle because it is a catabolic activity. Lifting weights help to balance that out. 

Do I Really Need to Start Lifting Weights?

Yes, YOU do! I recommend that a woman looking to start lifting weights seek out professional help. A certified personal trainer is well qualified to provide safe and proper advice for her.

Also, I recommend home DVD workout programs such Power 90, Slim in 6 and Chalene Extreme that have all proven to help women strength train properly.

Weight training is important for everyone to do. It helps with posture, weight loss, prevention of osteoporosis and other metabolic diseases. It does not require a lot to do it, so why not incorporate two days/week for 30 minutes or less to lifting weights!


Maurice D. Williams is the owner of Move Well Fitness in Bethesda, MD, and Assistant Professor of Health & Human Performance at Freed-Hardeman University.  He is a NASM Master Instructor and Master Trainer,  and is also certified with NASM as a Corrective Exercise Specialist, Performance Enhancement Specialist, Senior Fitness Specialist & Weight Loss Specialist, and as a Certified Strength and Conditioning Specialist by NSCA.

core-exercise-group-of-women

Core Exercise, Part 2: Training The Abs To Do Their Job

In a previous blog, Core Exercise, Part 1: Fad, Fashion or Fundamental?, I proposed that core exercise is not just about training the abs since the core is a more integrated, comprehensive functional unit that simply includes the abs as one element. In Part 2, I want to stress how the abs actually function – not based on EMGs or ultrasounds – in doing movements we train with in the gym that correspond to real life.

Motivated by an article in Women’s Health, “17 Back Exercises Every Woman Should Add to Her Workout ASAP“, I was pleasantly pleased to see exercises listed with a by-line that said “It’s not all about the abs, you guys”. The thrust of the article and exercises was that the back is important, too. I’d add that the back is MOST important and that anything you do to strengthen the back, especially with some of the unilateral exercises described, is even BETTER for the abs than crunches.

While some of the exercises were simply simple adaptations of traditional exercises, such as the overhand and underhand bent over row, or were clearly aimed at the anterior core – the abs – they highlight the message I often bring to my sessions with clients.

Core-Exercise,-Part-2:-Training-the-Abs-to-Do-Their-Job1

AS A PERSONAL FITNESS TRAINER, IT’S MY GOAL TO PROVIDE SAFE AND EFFECTIVE EXERCISES THAT ENHANCE A PERSON’S HEALTH, WELLNESS, AND FUNCTION.

With this mission statement, first and foremost in my mind when I approach a training session with whomever at whatever stage of health or fitness they are in, my goal is to train them to move and perform ADLs or recreational activities with less strain and stress to their bodies. Especially their spines!

Recognizing that many come in wishing to do something about their guts, I comply with some abs-specific exercises when they are ready for them. But first I aim to train the core as I defined it in the Part 1 blog.

Let’s, for now, leave out of consideration the person with a low back issue such as a ruptured disk or chronic low back pain (LBP). These kinds of issues require gentle step-by-step approaches akin to physical therapy-type exercises before venturing into real-life functional exercises just to get the core working. Which leads me to my framework for working the core, but really any muscle.

There are 5 layers to muscle function:

  1. activation
  2. endurance
  3. strength
  4. power
  5. speed

Activation is a neuromuscular bioelectrical event whereby an exercise causes muscles to engage – that is, to fire – so that they learn or re-learn how to do what they were supposed to do. Imagine a stroke victim unable to move a toe. It is the essence of core stabilization. If therapists can get the person’s focus on moving the toe, and the toe actually moves again, that means nerve signals went from the brain down the spine and into the legs all the way to the toe. When the muscle receives those signals, even though it’s been weakened by the stroke itself, it starts to twitch. When the twitch becomes large enough, it fires enough fibers to make the toe move… even a little.

When it comes to core exercise, first we want the muscles to get engaged, to fire, but not to generate movement – that is, to first do an isometric hold. So, for example, taking the bent over row as a case in point, by bending over, with both feet on the floor and one hand supported on a bench or chair, the other holding a weight, the core engages to prevent rotation toward the side that holds the weight. In other words, almost every muscle of the core is activated even as you focus on bringing the weight toward the ribs. Take the support arm away and now the core is super-activated as it now has to support the upper torso plus the weight(s). It’s not a back exercise anymore, it’s a total core exercise as even the abs engage to stiffen the spine against the pulls of gravity and of the lumbar erectors.

Endurance is the next phase of training. This doesn’t mean simply running for miles on end. It means that a muscle can be activated and engaged for longer periods of time than simply to make any particular movement. This entails multiple repetitions (reps) and sets and even exercises that target that muscle. This is initially done with lower resistances so that the exercise is learned properly and all moving parts and stabilizing parts are able to do their jobs properly.

Core-Exercise,-Part-2:-Training-the-Abs-to-Do-Their-Job2

When it comes to core endurance, we often do high reps of crunches or bridges and call it a day. But the reality is our core works even while sitting, especially while standing and most importantly while moving. Thus an exercise that engages core muscles in functional positions or patterns of movement is more functional than one that isolates one section at the expense of others.

For example, taking the alternating bent over reverse fly (#14 of the article above), we see a long lever arm moving outward to the side as the trainee tries to stay parallel to the floor. Each subsequent movement by each arm applies a torque to the core that tries to bend and twist it. Doing multiple reps actually trains the core to stabilize for a long period of time, more so than if you do both arms at the same time. For one thing, the anti-rotation component doesn’t exist to the same degree in the bilateral move as it does in the unilateral. For another, assuming you can do the same number of reps with a particular weight whether bilateral or unilateral, the time under tension is longer for the alternating reverse fly; almost double if not more. (One could argue that you could even use a higher load as you have more rest between reps doing one arm at a time.)

Strength is the ability to apply force… or resist load. This entails lifting heavier weights in order to optimize one’s ability to apply a lot of force. Usually, this is measured as a function of %RM, or percentage of maximal repetition. That is, if you can curl 30# one time, that is your 1RM; if you can do it 10 times, it’s your 10RM. Thus, if you do 15# curls, you are training at 50% of your 1RM.

The other way to look at it is by how many reps you are able to do. If you can do more than 12, you are essentially training endurance as you are now working below 50% 1RM. It is recommended you lift at loads that actually fatigue you anywhere from 8 to 12 reps to get strong.

AT THE LOWER END OF REPS, YOU ARE GETTING STRONGER WHILE AT THE UPPER END YOU’RE CLOSING IN ON ENDURANCE.

Core Exercise, Part 2: Training the Abs to Do Their Job3

For the core, even though it’s just another muscle, the break point could endanger the spine so it’s usually not recommended to hit with high loads. That said, many exercises we do in the gym do actually involve the core at extremely high loads and never require isolating it. For example, a low-rep, high-load squat or power lift engages the core at extremely high load even though we tend to observe the legs or arm movements. But we could also do a standing cable row with a very heavy resistance which would fatigue the upper body in 8-12 reps but recognize that the core is also heavily challenged, making this an effective strength exercise for the core itself.

Power is the ability to produce lots of force quickly; it’s a function of speed but does not require actual speed. When the body tries to move quickly but the resistance prevents it, you’re engaging muscles, especially fast twitch, white fiber muscles, to produce speed, but the weight slows you down. Watch a powerlifter and you’ll note that he/she is hardly moving fast but is trying to do so with great effort. Now that’s power!

For core power, something as simple and basic as a squat and curl on the way up, assuming the resistance is greater than you could lift if you were simply standing or sitting down, would engage the core muscles rapidly in order to stiffen the spine. Likewise, a push-press, which is a shoulder overhead press performed off a partial squat, with speed, would constitute core power. The muscles that stabilize the lumbopelvic region would have to engage rapidly to propel the weights upward from the shoulder, then would have to contract isometrically very quickly to stabilize the spine against any backward bending resulting from the momentum of the weights from in front of the center line to on or behind it. If done with one arm, now you have to resist a lateral bending force on the core, too.

Finally, there’s speed, the ability to produce a high velocity movement. We know speed when we see it, in running, biking, etc. but in resistance training, we are often put off by it. The ability to move a light load very fast actually puts the joint in a dangerous position. Going back to the article, there are two exercises that should not be done fast: #4, the Good Morning, and #15, the Stability Ball Back Extension. I prefer to think of these as endurance exercises, maybe shifting into strength, but not power or speed.

Core-Exercise,-Part-2:-Training-the-Abs-to-Do-Their-Job3

But how could we do a core exercise to simulate speed? My preference is for the tubing torso rotation, especially with a controlled stopping point. As this video shows, with a modest resistance, you can move quickly. However, I would suggest stopping at 45 degrees past the mid-point as the resistance declines rapidly beyond that; thus there’s no counterforce applied by the tubing as the spine approaches the terminus of the tissues themselves. Nonetheless, you can see how, with slightly more resistance and with a controlled end point, core speed could be trained here.

Which brings me to the end.

In sum, core training is not muscle-specific. It involves, includes, entails and integrates many of the muscles we associate with the core. It takes into account the various elements of muscle training, from activation to high speeds, from endurance to power. Core training does not require, in fact, I’d say it actually is violated, by isolation exercises except where the person’s initial status requires it.

CORE TRAINING IS NOT A FAD, NOR IS IT A SEPARATE PART OF A WORKOUT SESSION. IT CAN BE PART AND PARCEL TO ANY IF NOT ALL EXERCISES SIMPLY BY DOING THINGS ON ONE LEG, WITH ONE ARM, WITH RESISTANCES COMING FROM VARIOUS DIRECTIONS (GRAVITY-DOWN, CABLE OR TUBE -HORIZONTALLY OR DIAGONALLY).

Core is neither a fad nor a fashion, it is fundamental, and now you know why and what-for to take your training to the next level.

Originally printed on stepsfitness.com. Reprinted with permission. Images courtesy of STEPS Fitness.


Dr. Irv Rubenstein graduated Vanderbilt-Peabody in 1988 with a PhD in exercise science, having already co-founded STEPS Fitness, Inc. two years earlier — Tennessee’s first personal fitness training center. One of his goals was to foster the evolution of the then-fledgling field of personal training into a viable and mature profession, and has done so over the past 3 decades, teaching trainers across through country. As a writer and speaker, Dr. Irv has earned a national reputation as one who can answer the hard questions about exercise and fitness – not just the “how” but the “why”. 

walking shoes

Keep Walking: Benefits of Walking as Aerobic Exercise

Aerobic exercise (also known as cardio) is physical exercise of low to high intensity that depends primarily on the aerobic energy-generating process. “Aerobic” means “relating to, involving, or requiring free oxygen”, and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism.

Generally, light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time. What is generally called aerobic exercise might be better termed “solely aerobic”, because it is designed to be low-intensity enough so that all carbohydrates are aerobically turned into energy. The bulk of the energy in this type of exercise is due to mitochondria ATP production which relies on oxygen for the metabolism of carbs, proteins and fats for energy.

Health Benefits

Among the recognized health benefits of doing regular aerobic exercise are:

  • Strengthening the muscles involved in respiration, to facilitate the flow of air in and out of the lungs
  • Strengthening and enlarging the heart muscle, to improve its pumping efficiency and reduce the resting heart rate, known as aerobic conditioning
  • Improving circulation efficiency and reducing blood pressure
  • Increasing the total number of red blood cells in the body, facilitating transport of oxygen
  • Improving mental health, including reducing stress and lowering the incidence of depression, as well as increased cognitive capacity
  • Reducing the risk for diabetes (One meta-analysis has shown, from multiple conducted studies, that aerobic exercise does help lower Hb A levels for type 2 diabetics)
  • Reducing the risk of death due to cardiovascular problems

How to Walk Properly and Correctly to Keep Walking

Starting from the foundation of our body, our feet, we need to keep in consideration and balancing our weight through a tripod that includes our heel, big toe and small toe during our gait circle.

Gait is categorized into two phases: stance and swing. The stance phase occurs when the foot is on the ground. In young to middle-aged adults, the stance phase makes up 60% of the gait cycle. The remaining 40% of the cycle is spent in the swing phase where the foot is off the ground and being propelled forward.

The more we keep repeating this cycle in the correct form the more we keep producing the right pattern for our body to keep walking/exercising, planting the benefits for our longevity.

Additionally, we need to consider the alignment of the rest of the body. Thorax and Pelvis should be in the same line allowing breathing to go in a constant rhythm with the heart and lungs. Usage of the diaphragm and full expansion of respiratory muscles will allow extra oxygen intake, leading to better performance and eventually weight loss.

Body Performance Benefits

In addition to the health benefits of aerobic exercise, there are numerous performance benefits:

  • Increasing storage of energy molecules such as fats and carbohydrates within the muscles, allowing for increased endurance
  • Neovascularization of the muscle sarcomeres to increase blood flow through the muscles
  • Increasing speed at which aerobic metabolism is activated within muscles, allowing a greater portion of energy for intense exercise to be generated aerobically
  • Improving the ability of muscles to use fats during exercise, preserving intramuscular glycogen
  • Enhancing the speed at which muscles recover from high-intensity exercise

Neurobiological Effects:

  • Improvement in brain structural connections
  • Increase in gray matter density
  • New neuron growth
  • Improvement in cognitive function (cognitive control and various forms of memory)
  • Improvement or maintenance of mental health

Walking is widely recommended for its health benefits. According to a recent U.S. Surgeon General report on physical activity and health in America, more than half of the U.S. population does not participate regularly in any type of exercise. That physical inactivity can lead to poor health. It is time to start making better choices and better habits. Let’s start walking!

  • Walking can help you attain that trim figure you’ve been “dieting” to have. It allows you to burn off fat without losing muscle and without depriving your body of the essential nutrients it needs. And it can help tone your muscles and shape up your legs.
  • Before you begin walking for fitness with freestyle walking programs, you need to consider a few preliminaries, including your age and your overall health. It’s pretty easy to figure out that walking doesn’t require much in the way of equipment. One of the only, and by far the most important items that you’ll need, is a pair of comfortable walk­ing shoes. If you don’t take time and care in selecting your walking shoes, you may be in for some serious discomfort.
  • You also need to learn how to measure your heart rate and listen to your body, so you’ll know where to begin and how hard you need to work to increase your fitness and health. You may have heard similar claims made for other aerobic exercises, but consider this: The only exercise that will do you any good is the exercise you do, and walking is easy, as easy as putting one foot in front of the other.

Dimitrios Triantafillopoulos is a Master Personal Trainer, supporting people, athletes and other trainers to make them feel better with their body and themselves. He holds a Bachelor’s degree in Kinesiology and Sports Science, a Master’s Degree in Nutrition and Sport Fitness, as well as a Medical Fitness Specialty. Dimitrios has attended numerous seminars in Performance Training and Specialized Nutrition, and is also a Certified Instructor in Vibration (Power Plate) Acceleration Training and Electro – Stimulation Training. He is currently a Fitness Manager at Crunch Fitness in New York City.

male-trainer-female-client-gym

Motivational Interviewing to Drive Sustainable Behavior Change

Clients and Patients come to us because they want something to change about their life. That change could be the removal of physical pain, dealing with emotional distress, changing their nutrition in order to lose weight, or decrease the effect of diagnosed disease on their overall quality of life.

Interestingly, one’s desire to change doesn’t always lead to change. Change is abstract in that the new state of being that is desired doesn’t exist yet. Change is about the future. One’s future is connected to the present, which is the result of the past. Newton’s Laws of Motion give us a reference for thinking about change. In general, a thing will stay the same unless a force or energy acts on that thing. Therefore, change requires energy – and often sacrifice. Change can seem overwhelming and there may be fear of what might happen when change occurs. Old habits are hard to break. Even bad ones.

How can a practitioner from any discipline assist their client or patient to move from wanting to change to actually changing?

Motivational Interviewing (MI) is a communication strategy with tactical aspects designed to help the practitioner encourage the adoption of change behaviors. Change is about learning – learning not just a new way of thinking, but a new way of behaving.

Here is the most current definition:

“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.”  (Miller & Rollnick, 2013, p. 29).

What is the language of change?

Language (n.) – the principal method of human communication, consisting of words used in a structured and conventional way and conveyed by speech, writing, or gesture. (Oxford Language Dictionary)

Change (n.) – the act, process, or result of making different. (Merriam-Webster Dictionary)

Using the language of change can be as simple as speaking the synonyms for the word change within the questions and statements constructed in a conversation with your client or patient: alteration, difference, modification, redoing, refashioning, remaking, remodeling, revamping, review, revise, revision, reworking, variation

The definition of language includes the use of gestures as a part of the communication process.

Physical gestures reflect ideas that the speaker has about the problem, often ideas that are not found in that speaker’s talk.

“Gesture is an act of the body, and the body has been claimed to play a central role in cognition.” (e.g., Barsalou, 1999Glenberg, 1997Wilson, 2002Zwaan, 1999).

So what part of our physical body can be used to create and display physical gestures?

The face, the eyes, the hands, the trunk, just about any part of your body can be employed.

What physical gestures would be useful to employ when conducting a motivational interview?

Find Out More…

Learn more about Motivational Interviewing! Join Greg Mack for his webinar, Motivational Interviewing to Drive Sustainable Behavior Change. Register Now »


Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease.